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Wilfrid Casseron (Neurologist)
Marine, a 26-year-old young woman, killed herself in 2021 because she was unable to afford the migraine treatment she needed. His family today returns to his ordeal. How to explain such a situation? Insights from Dr Wilfrid Casseron, neurologist in Aix-en-Provence.
In 2021, Marine is 26 years old and has suffered from chronic migraines since the age of 8, which hamper her daily life. The year before, in 2020, she joined a clinical trial which allowed her to have access to a treatment which gave her relief. But the trial ends and Marine’s ordeal begins again, because the treatment is not reimbursed and the couple cannot afford it, due to lack of means. The CPAM of Drôme refuses to grant him financial assistance, “the insured’s resources were higher than the scale brackets allowing entitlement to this assistance. Two weeks after the refusal of the CPAM de la Drôme to grant her financial assistance, she will decide to end these days, in November 2021.
The difficulty of obtaining anti-CGRP in France
According to those close to the young woman, who recount her story in the columns of Parisian, Marine benefited during this clinical trial from a particular medication, called Aimovig. It belongs to the class of anti-CGRP, drugs effective in the management of chronic migraines refractory to other treatments.
This was the case for Marine, who was not relieved during her attacks by conventional treatments. During the trial, while she was taking Aimovig, her attacks were divided by “two or even three”, which allowed her to “live normally again”, explains her husband Nicolas. But at the end of the trial, she cannot continue to benefit from this drug. The only solution: buy it, which would cost him “a thousand euros per month”. A sum too large for the couple. Marine decides to ask the CPAM of Drôme for exceptional assistance to finance her treatment. She refuses him judging that “the insured’s resources were higher than the scale brackets allowing entitlement to this assistance. Two weeks later, she commits the irreparable.
Wilfrid Casseron, neurologist: “The management of chronic pain is still too unequal in France”
To better understand how this young woman got there, Doctissimo chose to interview Wilfrid Casseron, a neurologist in Aix-en-Provence. “Anti-CGRP drugs are not reimbursed by Social Security in France, and this decision is purely political.” denounces the doctor.
To allow certain patients to obtain them without paying, he sometimes uses indirect means, by hospitalizing them in a day hospital. “This is not a viable solution. The delays for this type of care vary between six and nine months and given the number of patients, this is untenable. In addition, it must be repeated over time, it is expensive and it takes up space that could be used by other patients. Social Security therefore pays for half a day of hospitalization in a day hospital, for treatment which will last ten minutes. With the 500 euros spent, we could treat two patients“.
23 European countries have chosen to reimburse these treatments
According to the Voice of Migraineurs, the association of patients suffering from this pathology, 23 European countries have chosen to reimburse this drug, but not France. “Generally speaking, it is the management of chronic pain that is still too uneven in France, because it is not profitable. However, there are 14 million people who suffer from chronic pain but the territorial network does not meet patient demand. calls back the doctor.
A dramatic situation for patients suffering from chronic pain in general. As for those affected by refractory migraines, 15% admit to having already thought about suicide, according to a recent survey by the association.